AIIMS November 2014 MCQ Key discussion

Discussion in 'AIIMS Nov 2013' started by samuel, Nov 10, 2014.

  1. samuel

    samuel New Member

    a picture depicting foramen ovale . which of the following does not pass through foramen ovale ?
    a.lesser petrosal nerve
    b.maxillary nerve
    c.sensory root of mandibular nerve
    d.motor root of trigeminal nerve
    Ans B
    Several nerves, arteries and veins pass through the foramen ovale. They are as follows:
    • Mandibular nerve, the third branch of the trigeminal nerve
    • Lesser petrosal nerve, a branch of the glossopharyngeal nerve.
    • Accessory meningeal artery (small meningeal or parvidural branch, sometimes derived from the middle meningeal artery)
    • Emissary veins (from the cavernous sinus to the pterygoid plexus)
    The otic ganglion is situated directly under the foramen, but is also transmitted through the foramen ovale.
    The ophthalmic nerve and maxillary nerve travel lateral to the cavernous sinus exiting the cranium via the superior orbital fissure and foramen rotundum

    @ Apoptosis is caused by
    a) Oliec acid
    b) Glucocorticoid
    c) Myristic acid
    d) Isoprenoid.

    • Saturated free fatty acids, palmitic acid and stearic acid, induce apoptosis
    • Oleic acid causes apoptosis and dephosphorylates Bad gene
    @ cri du chat chromosome 5

    Cri-du-chat (cat's cry) syndrome, also known as 5p- (5p minus) syndrome

    @ False regarding GIST- AIIMS Nov 2014 MCQs
    a) Originate from Cajal cells
    b) Most common mesenchymal tumour of gastrointestinal tract
    c) Prognosis depends on size
    d) ALK mutation is associated.
    Ans D
    • Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract
    • GISTs are thought to arise from interstitial cells of Cajal (ICC) that are normally part of the autonomic nervous system of the intestine. They serve a pacemaker function in controlling motility.
    • The purpose of radiologic imaging is to locate the lesion, evaluate for signs of invasion and detect metastasis. Features of GIST vary depending on tumor size and organ of origin. The diameter can range from a few millimeters to more than 30 cm. Larger tumors usually cause symptoms in contrast to those found incidentally which tend to be smaller and have better prognosis. Large tumors tend to exhibit malignant behavior but small GISTs may also demonstrate clinically aggressive behavior
    • Anaplastic lymphoma kinase (ALK) also known as ALK tyrosine kinase receptor or CD246 (cluster of differentiation 246) is an enzyme that in humans is encoded by the ALK gene.
    • The 2;5 chromosomal translocation is associated with approximately 60% anaplastic large-cell lymphomas (ALCLs). The translocation creates a fusion gene consisting of the ALK (anaplastic lymphoma kinase) gene and the nucleophosmin (NPM) gene: the 3' half of ALK, derived from chromosome 2 and coding for the catalytic domain, is fused to the 5' portion of NPM from chromosome 5.
    • The EML4-ALK fusion gene is responsible for approximately 3-5% of non-small-cell lung cancer(NSCLC).
    • Xalkori (crizotinib), produced by Pfizer, was approved by the FDA for treatment of late stage lung cancer

    # Pharmacology
    @ Fatal dose of lithium AIIMS Nov 2014 MCQs
    a) 8 g
    b) 6 g
    c) 4 g
    d) 2 g
    Ans B
    about 20 tablets of a lithium salt, or about 6 g should be the fatal dose.
    @ false about NSAIDs AIIMS Nov 2014 MCQs
    a) used in neuropathic pain
    b) decreases efficacy of hypertensives
    c) cause renal failure
    d) can be used topically
    Ans A
    • NSAIDs reduce renal blood flow and thereby decrease the efficacy of diuretics, and inhibit the elimination of lithium and methotrexate.[45]
    • NSAIDs cause hypocoagulability, which may be serious when combined with other drugs that also decrease blood clotting, such as warfarin.[45]
    • NSAIDs may aggravate hypertension (high blood pressure) and thereby antagonize the effect of antihypertensives, such as ACE Inhibitors.[46]
    • NSAIDs may interfere and reduce efficiency of SSRI antidepressants
    Globally, topical preparations are available for diclofenac, eltenac, felbinac, ibuprofen, ketoprofen, and piroxicam.
    Nociceptive and neuropathic pain are caused by different neuro-physiological processes, and therefore tend to respond to different treatment modalities. Nociceptive pain is mediated by receptors on A-delta and C-fibers which are located in skin, bone, connective tissue, muscle and viscera. These receptors serve a biologically useful role at localizing noxious chemical, thermal and mechanical stimuli. Nociceptive pain can be somatic or visceral in nature. Somatic pain tends to be well localized, constant pain that is described as sharp, aching, throbbing, or gnawing. Visceral pain, on the other hand, tends to be vague in distribution, paroxysmal in nature and is usually described as deep, aching, squeezing and colicky in nature. Examples of nociceptive pain include: post-operative pain, pain associated with trauma, and the chronic pain of arthritis. Nociceptive pain usually responds to opioids and non-steroidal anti-inflammatories (NSAIDS).
    Neuropathic pain, in contrast to nociceptive pain, is described as "burning", "electric", "tingling", and "shooting" in nature. It can be continuous or paroxysmal in presentation. Whereas nociceptive pain is caused by the stimulation of peripheral of A-delta and C-polymodal pain receptors, by algogenic substances (eg. histamine bradykinin, substance P, etc.) neuropathic pain is produced by damage to, or pathological changes in the peripheral or central nervous systems. Examples of pathological changes include prolonged peripheral or central neuronal sensitization, central sensitization related damage to nervous system inhibitory functions, and abnormal interactions between the somatic and sympathetic nervous systems.


    # Paediatrics
    Child with k/c/o bronchial asthma comes with respiratory distress rate 48/min cant speak 2 words,occasionsl wheeze.Saturation 95% .you have given 3 doses of salbutamol nebulisation then he started to speak a sentence but saturation falls to 85% AIIMS Nov 2014 MCQs
    A.Bronchomalacia
    B.R to left shunt
    C.Due to salbutamol
    D.Faulty pulse oxymeter
    Ans D

    @ Fatal dose of arsenic AIIMS Nov 2014 MCQs
    a.20-30 mg
    b.50-60 mg
    c.70-200 mg
    Ans C
    The acute minimal lethal dose of arsenic in adults is estimated to be 70 to 200 mg
  2. samuel

    samuel New Member

    # Pharmacology
    @ Fatal dose of lithium AIIMS Nov 2014 MCQs
    a) 8 g
    b) 6 g
    c) 4 g
    d) 2 g
    Ans B
    about 20 tablets of a lithium salt, or about 6 g should be the fatal dose.
    @ false about NSAIDs AIIMS Nov 2014 MCQs
    a) used in neuropathic pain
    b) decreases efficacy of hypertensives
    c) cause renal failure
    d) can be used topically
    Ans A
    • NSAIDs reduce renal blood flow and thereby decrease the efficacy of diuretics, and inhibit the elimination of lithium and methotrexate.[45]
    • NSAIDs cause hypocoagulability, which may be serious when combined with other drugs that also decrease blood clotting, such as warfarin.[45]
    • NSAIDs may aggravate hypertension (high blood pressure) and thereby antagonize the effect of antihypertensives, such as ACE Inhibitors.[46]
    • NSAIDs may interfere and reduce efficiency of SSRI antidepressants
    Globally, topical preparations are available for diclofenac, eltenac, felbinac, ibuprofen, ketoprofen, and piroxicam.
    Nociceptive and neuropathic pain are caused by different neuro-physiological processes, and therefore tend to respond to different treatment modalities. Nociceptive pain is mediated by receptors on A-delta and C-fibers which are located in skin, bone, connective tissue, muscle and viscera. These receptors serve a biologically useful role at localizing noxious chemical, thermal and mechanical stimuli. Nociceptive pain can be somatic or visceral in nature. Somatic pain tends to be well localized, constant pain that is described as sharp, aching, throbbing, or gnawing. Visceral pain, on the other hand, tends to be vague in distribution, paroxysmal in nature and is usually described as deep, aching, squeezing and colicky in nature. Examples of nociceptive pain include: post-operative pain, pain associated with trauma, and the chronic pain of arthritis. Nociceptive pain usually responds to opioids and non-steroidal anti-inflammatories (NSAIDS).
    Neuropathic pain, in contrast to nociceptive pain, is described as "burning", "electric", "tingling", and "shooting" in nature. It can be continuous or paroxysmal in presentation. Whereas nociceptive pain is caused by the stimulation of peripheral of A-delta and C-polymodal pain receptors, by algogenic substances (eg. histamine bradykinin, substance P, etc.) neuropathic pain is produced by damage to, or pathological changes in the peripheral or central nervous systems. Examples of pathological changes include prolonged peripheral or central neuronal sensitization, central sensitization related damage to nervous system inhibitory functions, and abnormal interactions between the somatic and sympathetic nervous systems.


    # Paediatrics
    Child with k/c/o bronchial asthma comes with respiratory distress rate 48/min cant speak 2 words,occasionsl wheeze.Saturation 95% .you have given 3 doses of salbutamol nebulisation then he started to speak a sentence but saturation falls to 85% AIIMS Nov 2014 MCQs
    A.Bronchomalacia
    B.R to left shunt
    C.Due to salbutamol
    D.Faulty pulse oxymeter
    Ans D
    #Forensic
    @ Fatal dose of arsenic AIIMS Nov 2014 MCQs
    a.20-30 mg
    b.50-60 mg
    c.70-200 mg
    Ans C
    The acute minimal lethal dose of arsenic in adults is estimated to be 70 to 200 mg

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